Use of radiation is not totally free of side effects. Clear explanations about what to expect will be given to you and your relative before the treatment starts and there will be opportunities throughout the course of treatment to talk over any problems. The main side effects to be aware of (apart from fatigue) depend on the area being treated. Side effects are divided into those that are immediate, ie that occur during and shortly after treatment, and those which may start months or years after the treatment was given.
Early side effects
– General tiredness is typical whatever the type of radiation being given; this is partly due to the treatment and partly due to” the demanding regime. Your relative should expect to rest more during the treatment and for a few weeks after it is completed.
– Redness of the skin similar to sunburn is usual when the skin itself is being treated or an area close to the surface, par¬ticularly under skin folds. Any soreness will heal quickly once treatment stops. The staff at the centre will offer advice on skin care and the use of body lotions and talcum powder. – Hair loss only happens if hair-bearing skin has been irradiat¬ed: the scalp, beard area, armpits or pubic area. The hair will usually grow again, but this depends on the dose of radiation that has been given. If bald patches remain, wigs are available for temporary or permanent cover in the same way as for chemotherapy patients.
– Difficulty in swallowing with a sore, dry mouth is com¬mon during treatment to the head and neck, and a sore throat is usual if the oesophagus is treated. Certain infections, such as thrush, are common and may need treatment with anti-fun¬gal therapy. Loss of taste may persist for a while. Pay careful attention to dental hygiene, use a mouth wash and take pain killers and avoid spicy foods and alcohol if the discomfort is too great.
– Diarrhoea, nausea and occasional vomiting can occur when the abdominal and pelvic areas are treated. Anti-sickness and anti-diarrhoea medicines help enormously and additional nourishing drinks prevent weight loss.
– Cystitis, causing frequency and burning when passing urine, may follow treatment to the bladder. The problem is short lived and can be treated with medication to increase the alkalinity of the urine.
– Somnolence or the ‘sleepy syndrome’ occurs about four to six weeks after radiotherapy to the brain; your relative may become very sleepy and have no energy for a week or two having had no problems when the treatment finished. Somnolence settles without treatment.
Later side effects
– Skin changes are rare with modern radiotherapy techniques, but if the skin itself has been treated then the affected area will become paler and the skin thinner; sometimes little blood ves¬sels show through.
– Lymphoedema may occur if surgery to lymph nodes is fol¬lowed by radiotherapy.
– Shortness of breath may occur a few months after a course of radiotherapy, and usually improves after a few weeks or with a short course of steroids. Occasionally it remains as a problem.
– Loss of fertility and an early menopause are unavoidable for younger women who receive radiation to the ovaries. Hor¬mone replacement therapy can be given to patients if menopausal symptoms are severe, and counselling will always be offered for those people who are distressed at the thought of being sterile.
– Loss of fertility for men may be avoided if one testicle only is being treated; if both testicles are affected, the option of storing sperm is available. Radiotherapy to the pelvic area has no direct affect on sexual function.
– Narrowing of the vagina can cause discomfort after radioactive implants. Use of lubricants and regular dilation of the vagina can help to overcome the problem.